The deployment of cloud-based services can be a challenge for healthcare providers of any size: For the Cleveland Clinic, which runs a 170-acre campus in Cleveland as well as hospitals across Ohio, Florida and Nevada, a successful transition strategy began with knowing where the cloud was going to be of most use.

Dr. William Morris, executive medical director of innovation at the Cleveland Clinic, told Healthcare IT News that leveraging the cloud is like using any other tool in the IT tool belt: Just like the right tool has the right purpose, not everything needs to go up to the cloud, nor should it.

Leasing instead of buying

“Cloud becomes a very interesting tool when you start considering cost, speed and performance,” Morris said. “We look at cloud as a means to spin up and spin down environments that are temporary, say if we are looking at testing a new capability – it’s sort of like leasing the infrastructure instead of buying it.”

For other healthcare providers migrating to the cloud, Morris said it is important for them to remember that as a health system they want to focus their resources and dollars on patient care.

“Ultimately, the way we leverage these tools is because we want to provide the best patient care that is scalable, safe and has the lowest cost,” he said.

He pointed to Cleveland Clinic’s human resources system, which was moved to the cloud so the organization wouldn't have to worry about doing backups or disaster recovery issues, because all of that is part of the vendor’s cloud-based offering.

A perpetual learning curve

Part of the process of moving to cloud-based applications and systems means a perpetual learning curve where new technology and new services are constantly being introduced, so there is a continuous level of engagement paramount to the success of deployment.

“No technology is smooth sailing – there’s an adoption curve and a trust curve,” Morris explained. “There’s a lot of change management that goes along with this, along with understanding and trust – it takes a lot more due diligence from our cybersecurity team, and from all the stakeholders involved.”

He said the No. 1 thing to do when planning a move to the cloud is education – the cloud is not a “set it and forget it” type of technology.

“You have to constantly look at performance metrics, costs – it’s not a quick turnkey solution,” Morris noted. “Seek recommendations, learn from others. For any organization adopting a new technology, getting a trusted advisor is par for the course, especially around healthcare where privacy and security are so essential. You want to know exactly who’s on the other end of that connection.”

Security and information governance

When it comes to pain points, Dr. Abed Saif, founding partner and director of cybersecurity advisory services specialist AbedGraham, said the most common questions he fields come down to security and information governance.

“A lot of hospital executives are concerned about how patient data will be handled and what the risks will be in terms of critical system downtime,” Saif explained. “No system will be foolproof, so it’s essential to rigorously assess your potential suppliers as a part of market research and procurement processes. This means asking tough questions about the healthcare expertise of suppliers and their ability to help providers mitigate clinical risks.”

Deloitte’s Chief Digital Officer for Healthcare Jason Wainstein explained because healthcare provider IT environments comprise primarily packaged applications, this creates a dependency on the software vendor’s ability to support the application in a cloud environment.

“This means understanding the readiness of the software vendor to support the application in a cloud environment is a key input to the migration,” he said.

Organic growth over time

He pointed out that the IT environment for healthcare providers is one that has typically grown organically over time.

“As a result, the environment is typically complex with many dependencies between applications and systems,” Wainstein said. “This complexity can make planning for the migration a daunting task as the dependencies must be thoroughly understood in order to avoid disruption of service or creation of performance issues.”